Development and Validation of the Mental Health Attitude Survey for Police

Police officers often lack sufficient mental health training and knowledge of mental illness to manage the risks associated with emotionally disturbed person (EDP) encounters. Still, it is not clear how much mental health training police officers actually need and, to date, there are no measures for police departments to use to determine officer attitudes toward dealing with EDPs. This led to the development of the Mental Health Attitude Survey for Police (MHASP), a modification and compilation of previously developed and newly developed items, which can be used to measure the effectiveness of mental health crisis training curricula in improving police attitudes toward persons with mental illnesses. A sample of 412 police officers from a major city police department in the northeast anonymously completed the MHASP. The results provide good evidence that the MHASP is a reliable and initially validated measure of police attitudes toward persons with mental illnesses.     

Interviewing persons with mental illness charged with murder or attempted murder: a retrospective review of police interviews

Individuals with a mental illness may be particularly vulnerable during police interviews. Assessing fitness for police interview is vital for ensuring procedural fairness. This article reports the findings of a retrospective review of 31 police interviews of mentally ill persons charged with murder (n?=?18) or attempted murder (n?=?13) who appeared before the Queensland Mental Health Court. Police interviews were conducted for all murder and 50% of attempted murder cases. Possible or overt mental illness symptoms were present in all interviews. Symptoms of mental illness were pervasive in 36.7% of interviews, intermittent in 43.3% of interviews and seldom in 20% of interviews. Support persons were present for 9.7% of interviews, and legal representation was not present for any interview. These findings highlight the need to enhance access to support persons during interviews. Intersectoral collaboration between mental health services, forensic medical officers, police, public guardians and the legal sector is needed.     

参加第二十九届北京奥运会安全保卫工作军人的心理压力及相关因素

目的 探讨参加第二十九届北京奥运会安全保卫工作军人(以下简称"安保军人")的心理健康与职业压力及相关因素的关系.方法 采用随机整群取样法,使用<军人职业压力量表>和<军人心理疾病预测量表>(MDPSS)对631名安保军人(研究组)及587名非安保军人(对照组)进行测试.结果 (1)研究组和对照组的MDPSS及职业压力大部分因子间差异均有统计学意义(P＜0.05或P＜0.01).(2)研究组官兵的心理素质、职业压力与其心理障碍的发生具有明显的正相关性(r为0.14～0.70,P＜0.01).(3)影响参加奥运会安保军人心理健康的主要因素是心理防御不良、应激源、领导能力、成长经历、个性内向、婚姻、军旅特殊生活和社会支持缺乏.结论 参加奥运会安保军人心理健康受到明显影响.     

Factors Affecting Stress and Mental Health During the COVID-19 Pandemic

ObjectiveThis study examined the factors influencing the mental health and stress of individuals during the coronavirus disease-2019 (COVID-19) pandemic. MethodsA total of 600 participants were enrolled in this anonymous questionnaire survey that included questions on their demographic profiles and experiences related to the COVID-19 pandemic. The COVID-19 Stress Scale for Korean People (CSSK), Warwick–Edinburgh Mental Wellbeing Scale, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and Multidimensional Scale of Perceived Social Support were used. Data were analyzed using multiple regression to identify the factors affecting the total CSSK scores and the scores of each of the three CSSK subscales. ResultsMultiple regression analyses revealed that the severity of insomnia, sex, degree of income decline, occupation, religion, education level, marital status, residential status, level of social support, and degree of depression and anxiety had significant relationships with COVID-19-related stress. ConclusionWe identified factors affecting stress and mental health in the general population during the COVID-19 pandemic. Our findings may be helpful in providing an individualized approach to managing the mental health of the public. We expect that the results of this study will be used to screen high-risk individuals vulnerable to stress and to establish policies related to the public health crisis.     

Appalachian public health nursing: Mental health component in eastern Kentucky

The Manchester Project, and its attendant public health nursing activity, is described as a unique mental health program in the commonwealth of Kentucky. It continues to operate within the existing framework of four local county health departments in eastern Kentucky, and utilizes much public health technique, personnel, and methodology. By focussing upon the intrinsic mental health component of public health work, the project demonstrates an effective way of meeting community mental health needs in rural, impoverished areas.This paper was presented at the annual meeting of the American Public Health Association, Miami Beach, Fla., October 26, 1967, at a session on Mental Health Services Today in Rural Areas.     

Severe Domestic Squalor by John Snowdon,Graeme Halliday,and Sube Banerjee

This paper examines police enforcement of the Vagrants, Gaming &; Other Offences Act 1931 (Qld) and the Mental Health Act 2000 (Qld) and the implications for Brisbane's homeless population. Research was obtained through field work conducted with Brisbane police officers and an experienced social worker. Findings revealed that repeal of the Vagrants, Gaming &; Other Offences Act 1931 (Qld), as advocated by various community groups, would result in little if any change to current police practices in Brisbane. It was also found that Queensland police do not receive adequate training to enable them to respond appropriately to mental health issues in the homeless community. However, rather than holding police responsible for exacerbating the problems of the homeless through their actions or lack thereof, it is suggested that it would be more prudent to employ trained service providers to meet the various needs of the homeless community.     

Role of psychiatrists in the public mental health system

This paper examines the contributions of the psychiatric profession within the public mental health system. Following a discussion of the current status of psychiatry and the public mental health delivery system, the author outlines a number of key recommendations regarding the appropriate role of psychiatrists in public systems. The author emphasizes the importance of the public mental health system in all areas of psychiatric practice.Dr. Miller was Commissioner of the Texas Department of Mental Health and Mental Retardation from February 1982 to April 1988, and served previously as State Mental Health Commissioner in Georgia and New Hampshire.This paper was a keynote address at the Conference on Improving Florida's Services for the Mentally Ill: The Role of Psychiatry, held on October 7–8, 1986 in Tallahassee, Florida. This conference was organized by the Florida Mental Health Institute, University of South Florida, and sponsored by the Florida Department of Health and Rehabilitative Services through the Committee on Public Psychiatry.     

Development, item analysis, and initial reliability and validity of a multiple-choice knowledge of mental illnesses test for lay samples

The public's level of mental health literacy remains low, despite growing access to information regarding mental illnesses. Because few measures exist to assess the level of knowledge of mental illnesses in lay samples, the Multiple-Choice Knowledge of Mental Illnesses Test (MC-KOMIT) was developed, initially for use in a study involving police officers, some of whom received 40 h of training focused on recognizing mental illnesses, using verbal de-escalation techniques, and making mental health referrals when appropriate. This report details the initial development of the 100 questions in the item bank and the eventual selection of the final 33 items that were retained. For these 33 items, internal consistency was demonstrated, and test-retest reliability was examined among officers not in the mental health-related training who completed the test on Monday morning and again on Friday afternoon. Construct validity was examined by three hypothesis tests: the MC-KOMIT was sensitive to change related to the educational intervention, scores were significantly correlated with years of educational attainment, and officers reporting past or current treatment for a mental health problem scored higher than those without such a history. This initial report suggests that the MC-KOMIT may be useful in quantifying knowledge of mental illnesses in police officers and other diverse lay samples.     

Mental health in older adult recipients of primary care services: is depression the key issue? Identification,treatment and the general practitioner

OBJECTIVES: Mental health services for older people in primary care are relatively underdeveloped. This study has sought to determine the nature and extent of mental health problems in older people presenting to primary care and to compare this with the detection and management of mental health problems by the primary health care team (PHCT). METHOD: Participants were patients aged 65 years and above attending a representative inner city general practice. Screening tools included the General Health Questionnaire (GHQ-28), Hospital Anxiety and Depression Scale (HADS), Mini Mental State Examination (MMSE). The PHCT used a brief checklist to rate participants for the presence of mental health problems. Follow-up interviews using the Geriatric Mental State (GMSA), Cambridge Examination for Mental Disorders in the Elderly (CAMDEX)-cognitive subscale (CAMCOG), National Adult Reading Test (NART), were carried out. RESULTS: A high level of psychological morbidity was identified at screening (48.1%). There was a considerable degree of agreement between the HADS and GMSA, and the MMSE and GMSA at follow-up. Agreement rates between the PHCT and initial screening tools were low suggesting under-recognition of mental health problems at primary care level by the PHCT. Contributory factors included: short consultation times with a concentration on physical symptoms; few patients presenting explicitly with mental health problems; few decisions to treat or refer patients; and the general practitioners tended to monitor, or defer decisions. CONCLUSIONS: This study found lower levels of severe mental health problems, especially depression, than reported elsewhere, but higher prevalence of psychological distress. High levels of physical and mental health co-morbidity were found. These findings suggest that planning for primary care services needs to adopt a flexible assessment model. The development of effective, time-limited protocols and screening tools to assist the PHCT in improving their identification rates is recommended. This needs to be supported by the availability of appropriate treatments for the psychological distress.     

Police as a community mental health resource

In their pathways to the state mental hospital, almost 50% of mentally ill patients and their families from Baltimore utilize the police as a community resource. To better understand why so many people use the police for help with mental problems, a comparison was made between first admission patients who used the police (N=17) and those who used more conventional medical resources (N=35). The results indicate that families decide to call the police because other, more appropriate, resources are not as accessible and will not offer services to recalcitrant patients. Until community mental health facilities develop more active evaluation and treatment programs for reluctant patients, the police will continue to serve a needed role in the care of the mentally ill.This study was performed when the author was associated with the Department of Mental Hygiene of The Johns Hopkins University School of Public Health and Hygiene. The research was financed by the Henry Strong Denison Fund for Medical Research. The author appreciates the encouragement of Professor Paul V. Lemkau and the technical assistance of Mrs. Mary Grotefend, R.N.     

An educational program in mental health statistics

The development and present status of a master's level educational program in mental health statistics at University of North Carolina School of Public Health are desrihed. The program educates applied biostatisticians whose field is mental health, especially community mental health. It contains core coursework in biostatistics and public health, supplemented by a practicum or field training experience and by newly developed courses in mental health statistics. These new courses are taught by faculty from the fields of biostatistics, mental health, and community psychiatry. Master's degree students were first accepted into the program in fall, 1968, and the program recently has been expanded to include training at the doctoral level.Brogan, a biostatistician, was formerly Assistant Professor of Biostatistics at University of North Carolina School of Public Health, Chapel Hill, North Carolina, and is currently Associate Professor of Statistics and Biometry at Emory University, Atlanta, Georgia 30322. Dr. Greenberg, a biostatistician, was formerly chairman of the Biostatistics Department at UNC School of Public Health and is currently Dean of UNC School of Public Health. The program described here was supported by grant MH10373 from the National Institute of Mental Health to the Biostatistics Department of UNC School of Public Health. Support is being continued under grant 1-T01-MH12602.     

Anxiety and depression and their influence on the quality of life after total hip replacement: preliminary report

Objective. The study investigated health-related quality of life in relation to mental status (anxiety and depression) and demographic factors in patients before and after total hip replacement due to osteoarthrosis. Methods. The SF-36, HADS, socio-demographic data questionnaire was delivered to a group of 184 subjects (108 females, 76 males) at the mean age at the time of surgery of 59 years. Questionnaires were delivered to the subjects 2 weeks before the surgery and 6 months after the operation (by mail). Results. Patients after hip replacement showed significant improvement in health-related quality of life in most domains of SF-36 score and summary scale of PCS (Physical Component Summary Scale) and MCS (Mental Component Summary Scale). They also showed improvement in mental status. Elderly patients were more likely to show worse score in MCS and PCS before and after surgery. BMI (body mass index) was correlated only with preoperative PCS. Mental status was associated with postoperative PCS and MCS. Patients who were satisfied with the results of the surgery showed higher PCS and MCS score. Conclusion. Hip replacement surgery brings significant improvement to the quality of life. Age and mental status of those patients influence markedly their postoperative performance.     

The impact of killing and injuring others on mental health symptoms among police officers

This study examined the relationship between killing or seriously injuring someone in the line of duty and mental health symptoms in a sample of police officers (N = 400) who were first assessed during academy training and at five additional time points over three years. We found that nearly 10% of police officers reported having to kill or seriously injure someone in the line of duty in the first three years of police service. After controlling for demographics and exposure to life threat, killing or seriously injuring someone in the line of duty was significantly associated with PTSD symptoms (p < .01) and marginally associated with depression symptoms (p = .06). These results highlight the potential mental health impact of killing or seriously injuring someone in the line of duty. Greater attention to mental health services following these types of exposures can serve as a preventative measure for police officers who have been negatively impacted.     

Mental health care in Egypt: Review of current state,policy, and needs

This study aims to analyze the new Egyptian mental health law from a rights perspective in order to measure its compatibility with established human rights principles and the international standards that guide the practice of the mental health care. At the same time, the study considers the status of psychiatric care and basic mental health services for people with mental disorders in Egypt after several recent national upheavals along with the national prevalence of psychiatric disorders in the country. It will address the needs and the challenges facing current practice, with a discussion of some suggestions for improvements. Relevant data bases were searched (Medline, PubMed, and Cochrane library of systemic reviews and clinical trials) with the following Mesh terms: “mental disorders,” “substance-related disorders,” “Egyptian Mental Health systems,” and “Egyptian Mental health laws.” Articles published since 2000 were prioritized. In the latest years, a considerable gap between mental healthcare needs and available services in Egypt has been documented. There is comprehensive mental health legislation to enforce the rights of persons with mental disorders; but there is a lack of firm policy for implementation of interventions. The transformation of hospital-based to community-based mental health and the building of accessible services are necessary. Egypt urgently needs a national assessment of the deficiencies of its mental health system. The assessment would provide evidence and reliable information on existing needs and the barriers to accessing mental health care. The outputs of such an assessment will be helpful in finding locally and culturally sensitive solutions to reduce the mental health gap and can then be used in lobbying public opinion to rectify these conditions.     

The association between social support and the mental health of social workers and police officers who work with unaccompanied asylum-seeking refugee children’s forced repatriation: A Swedish experience

This study aims to contribute to the knowledge of social support and its association with mental health amongst social workers and police officers in forced repatriation work of unaccompanied asylum-seeking refugee children. Nationally distributed surveys to social workers and police officers with and without experience of forced repatriation were used, measured by an abbreviated version of the Interview Schedule for Social Interaction (ISSI), and analyzed by univariate and multivariable regression models. Social workers in forced repatriation showed significantly poorer mental health than other social workers, but simultaneously relatively high access to social support. Irrespective of working with forced repatriation, police officers reported relatively high access to social support, but no difference in mental health. Furthermore, low levels of satisfaction with social interaction and close emotional support increased the odds of psychological disturbances for police officers in forced repatriation. Findings are discussed with special regard to the complexity of forced repatriation, particularly when children are the focus.     

Mental health training for law enforcement professionals

The purpose of this pilot study was to determine topics of interest and preferred modalities of training for police officers in their work with persons with mental illness. Police officers across Massachusetts attending in-service mental health training were asked to rate the importance of potential mental health topics and the effectiveness of potential training modalities on a Likert-type scale. Additional data collected included the officer's experience, level of education, motivation for attendance, previous attendance of post-academy mental health training, and preferences for length, frequency, training site, and trainer qualifications. A t test was used to determine if there were significant differences (p < .05) between those who volunteered and those who were mandated to attend the training. Repeated-measures ANOVAs were used to determine if there were significant differences (p < .05) between mental health topics and lecture formats and to determine the effect of education and experience on the results. Although all topics suggested were rated, primarily, as fairly important, the topics of Dangerousness, Suicide by Cop, Decreasing Suicide Risk, Mental Health Law, and Your Potential Liability for Bad Outcomes were given the highest ratings. Role-playing was rated significantly lower than other training modalities, while Videos and Small Group Discussion had the highest mean scores. Level of prior education had no significant effect on the ratings, but officers with more experience rated the importance of mental illness as a training topic significantly higher than officers with less experience. This survey suggests that police officers are interested in learning more about working with persons with mental illness and view it as an important aspect of the job.     

Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel

A full-scale public health response to disasters must attend to both the physical and mental health needs of affected communities. Public health preparedness efforts can be greatly expanded to address the latter set of needs, particularly in light of the high ratio of psychological to physical casualties that often rapidly overwhelms existing mental health response resources in a large-scale emergency. Psychological first aid--the provision of basic psychological care in the short term aftermath of a traumatic event--is a mental health response skill set that public health personnel can readily acquire with proper training. The application of psychological first aid by public health workers can significantly augment front-line community-based mental health responses during the crisis phase of an event. To help achieve this augmented response, we have developed a set of psychological first aid intervention competencies for public health personnel. These competencies, empirically grounded and based on best practice models and consensus statements from leading mental health organizations, represent a necessary step for developing a public health workforce that can better respond to the psychological needs of impacted populations in disasters.     

监狱警察压力、心理健康素质与心理健康的关系

目的 探讨监狱警察压力、心理健康素质和心理健康之间的关系.方法 采用方便抽样方法进行抽样,使用自编一般资料调查表、自编监狱警察压力量表、中国成年人心理弹性量表（RTS-CA）、中国成年人人际健康素质量表（IHDS-CA）和症状自评量表（SCL-90）对北京市218名监狱警察进行测查.以心理弹性、人际素质、压力、心理健康水平为变量构建路径分析模型.结果 （1）监狱警察在SCL-90的躯体化、抑郁和焦虑分量表上的评分显著高于全国成人常模（P＜0.01）.（2）路径分析模型各拟合指数为CMIN=1.17,GFI=0.93,CFI=0.93,RMSEA=0.031,模型整体路径显著（P＜0.01）.结论 监狱警察的心理健康水平较低,压力通过心理弹性、人际交往素质而影响监狱警察的心理健康水平,强化心理健康素质是维护监狱警察心理健康的有效途径.     

Active ingredients in anti-stigma programmes in mental health

This paper draws upon a review of the relevant literature and the results of the recent Mental Health Awareness in Action (MHAA) programme in England to discuss the current evidence base on the active ingredients in effective anti-stigma interventions in mental health. The MHAA Programme delivered educational interventions to 109 police officers, 78 adults from different community groups whose working lives involved supporting people with mental health problems but who had received no mental health training and 472 schools students aged 14–15. Each adult target group received two intervention sessions lasting two hours. The two school lessons were 50 minutes each. Knowledge, attitudes and behavioural intent were assessed at baseline and follow-up. In addition focus groups were held with mental health service users to explore the impact of stigma on their lives and facilitators of educational workshops were interviewed to provide expert opinion on ‘what works' to reduce psychiatric stigma. Personal contact was predictive of positive changes in knowledge and attitudes for the school students but not the police officers or community adult group. The key active ingredient identified by all intervention groups and workshop facilitators were the testimonies of service users. The statements of service users (consumers) about their experience of mental health problems and of their contact with a range of services had the greatest and most lasting impact on the target audiences in terms of reducing mental health stigma.     

Quality of life in multiple sclerosis: the impact of depression, fatigue and disability.

This study deals with the assessment of quality of life and its main clinical and demographical determinants in a clinical series of 103 patients with multiple sclerosis (MS) (37 men; 66 women; mean age 44.89 years; mean disease duration 12.40 years; mean EDSS score 4.07). We used the MSQOL-54 inventory, a disease-specific instrument recently validated in an Italian population. Each patient underwent a complete clinical assessment, including that of disability status (Expanded Disability Status Scale), cognitive function (Mini Mental State Examination), depression (Hamilton Rating Scale for Depression) and fatigue (Fatigue Severity Scale). In terms of Pearson's correlations, there was a moderate inverse relationship between disability level and the MSQOL-54 physical composite score, and a moderate to strong inverse correlation between depression or fatigue severity and both the physical and mental composite scores. In a stepwise linear regression analysis, depression, fatigue and disability level were confirmed to be significant and independent predictors of quality of life. Quality of life instruments can help to provide a broader measure of the disease impact and to develop a care program tailored to the patient's needs.